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EVERETT, WASH. ai <br />Approved By <br />The Undersigned — R FAT NO PTW W _57- E U I L DI= R- SN C. <br />Hereby applies for permission to—i.I2rt -L. A, 16 ' Qhl/ <br />At the following location /,o / Z — 7/ /—II J <br />/G. 1!�77/ <br />Date Approved <br />Dl <br />SKETCH % <br />(Work to be done) <br />I <br />I r <br />n <br />0 <br />I <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and oil claims for damages that may arise because of the <br />installation end maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />V GNHY b9G <br />(ND SCALE <br />Inspeclor's Signature <br />-57-4-7/ <br />Dale <br />36116 <br />Uri IV[\JAY .SECTION.:_:•' <br />W <br />A I <br />t <br />Varion,e Required <br />Yes <br />No <br />ee- ��',�. ��� lam' <br />Signature of licant <br />Address <br />7-f 7 • 7?/ e <br />Telephone Number <br />Fee <br />DEPT. <br />e/ri <br />Water "u.c Y • — <br />Street <br />Traffic — <br />Planning <br />Call Engineering Dept. 259 8903 I PROVIDE FOR <br />24 Hours before NOTE <br />i PROPER DRAINAGE <br />Construction is started. CIIECY. WITH WATER <br />DEPT. FOR WATER LINE <br />LOCATIONS BEFORE EXCAVATION <br />